Florida earns a 'D' in kids' dental health report

Florida needs to put more teeth in its policies to protect children's dental health, if the results of a new national report by the Pew Children's Dental Campaign is any judge.

The report, released publicly Tuesday, gives the Sunshine State a "D" for failing to provide adequate access to what health officials consider a critical yet painless and cost-effective prevention tool: the sealant, a clear, plastic coating painted on cavity-prone teeth to ward off decay.

Florida joined 14 other states in receiving a "D." Five others and the District of Columbia got an "F." Just five states — Maine, New Hampshire, Alaska, North Dakota and Wisconsin — scored an "A." The grades were calculated based on points scored on four benchmarks: availability of school-based sealant programs; hygienist supervision regulations; data collection participation; and whether the states met federal public health objectives on sealants.

"If we just did the basic things, it would dramatically reduce oral health disease and improve quality of life, and sealants are one of the easiest things we can do — that and tooth brushing," said Roderick K. King, executive director for the Florida Public Health Institute.

Sealants — usually applied around second grade, shortly after kids' permanent molars appear — act as a barrier to decay-causing bacteria and cost about one-third the price of a filling. A Centers for Disease Control and Prevention task force found in 2002 that after this sealant treatment, molars — the teeth most likely to grow cavities — typically see a 60 percent decrease in tooth decay. The panel strongly recommended school-based dental sealant programs to help reach low-income children, those most prone to cavities and least likely to get preventive care.

A comprehensive U.S. health survey from 2009-10 found that half of teens ages 13 to 15 had received sealants on one or more of their permanent teeth, even though the coating has been commonly available since the 1980s.

The report raps states like Florida for doing relatively little to make the sealants available to low-income, school-aged children. In one benchmark, the state scored a "D" for having sealant programs in fewer than 25 percent of its low-income schools.

"I very rarely hear about schools around here having them," said Boynton Beach pediatric dentist Dr. Lisa Feldman. "It would be excellent if they did because, unfortunately, I look at a lot of decay."

The state also failed two other benchmarks — for never participating in a national data-collection system and for not meeting federal public health objectives calling for sealants to be applied to the molars in at least half of all kids.

Florida did get a top mark in a fourth category, for passing a law allowing dental hygienists to apply sealants without first requiring a complete dental exam, making them more easily available. But according to the Florida Dental Hygiene Association, even that advancement has been seriously hampered by state Medicaid payment guidelines that still require a dentist to sign off on sealants before they can be reimbursed.

"Less than 10 percent of Florida's dentists participate in the state dental Medicaid program, primarily because of very low reimbursement rates," said Dr. Frank A. Catalanotto, chairman of Oral Health Florida, an arm of the Florida Public Health Institute.

The lack of access to care, Catalanotto said, means more low-income children seek emergency treatment for progressed dental problems in hospital ERs. In 2010, more than 15,000 Florida children did just that, the Florida Public Health Institute found.

"This is a national and state tragedy in the richest country in the world," he said.

The Florida Public Health Institute is pulling stakeholders together to strategize on how to improve the state's performance, King said.

"What does it say about a state when you're not doing what you can to prevent the burden [of tooth decay]?" said Dr. Bill Maas, an adviser to the Pew Children's Dental Campaign.